Objectives Little is known about local access-site complications and upper extremity dysfunction after transradial percutaneous coronary procedures (TR-PCP). This systematic review study aimed to summarise the current knowledge on the incidences of access-site complications and upper extremity dysfunction after TR-PCP. Methods Two independent, trained investigators searched MEDLINE, EMBASE and CENTRAL for eligible studies published before 1 January 2015. Also, they hand-searched the conference proceedings of the annual scientific sessions of the American College of Cardiology, the American Heart Association, European Society of Cardiology, and the Trans-catheter Cardiovascular Therapeutics. Inclusion criteria were cohort studies and clinical trials discussing the incidence of access-site complications and upper extremity function after transradial percutaneous coronary intervention (TR-PCI) and/or transradial coronary angiography (TR-CAG) as endpoints. Results 176 articles described access-site complications. The incidence is up to 9.6 %. Fourteen articles described upper extremity dysfunction, with an incidence of up to 1.7 %. Upper extremity dysfunction was rarely investigated, hardly ever as primary endpoint, and if investigated not thoroughly enough. Conclusion Upper extremity dysfunction in TR-PCP has never been properly investigated and is therefore underestimated. Further studies are needed to investigate the magnitude, prevention and best treatment of upper extremity dysfunction. Optimising TR-PCP might be achieved by using slender techniques, detection of upper extremity dysfunction and early referral to a hand rehabilitation centre.

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doi.org/10.1007/s12471-015-0747-9, hdl.handle.net/1765/84835
Netherlands Heart Journal
Department of Cardiology

Zwaan, E. M., Koopman, A. G. M. M., Holtzer, C. A. J., Zijlstra, F., Ritt, M. J. P. F., Amoroso, G., … IJsselmuiden, A. (2015). Revealing the impact of local access-site complications and upper extremity dysfunction post transradial percutaneous coronary procedures. Netherlands Heart Journal (Vol. 23, pp. 514–524). doi:10.1007/s12471-015-0747-9